The Future of Care Delivery Through the Health IT Lens

Coming off the heels of our ninth annual ReviveHealth Summit, I am reminded why I love health technology so much. This event gathered 100 financial and managed care leaders from health systems to discuss their most complex payer negotiation and employer engagement strategies. And throughout it all, I heard one resounding drumbeat: data. Data. DATA.

Yes, I am biased to see health IT wherever I go; but at this event, the common theme was undeniable. In this two-part blog series, I’ll explain why. Our first blog will hit on the Summit’s compelling keynotes, uncovering the key issues facing today’s providers as seen by national experts covering health system strategy, health policy, and digital health.

Let’s start with Monday night’s opening talk from Nate Kaufman, an industry luminary who consults with Boards and leadership groups of health systems across the country. After finally defining what population health is – a two-step process of identifying a population, then creating a delivery system to reach and manage them – he shook up the room with his claim that providers should only take on performance risk, never actuarial.

And how does one do this? Through data and peer leadership. “Don’t let this be your Kodak moment,” Nate demanded. Change is coming and those who don’t begin measuring themselves and continuously improving will be left behind.

The next morning, policy expert Paul Keckley accused healthcare of being “not a system, but a confederacy of independent self-interests.” CMS is trying to change this with a yin and yang strategy of ACOs and bundled payments, as consolidation is forcing a trend towards super-regional systems that are beholden to increasing demands from the business and employer world.

To answer those demands, providers have to pivot around narrow networks, reference pricing, bundled payments, and wellness models. And how can that be accomplished? Only through redefining their core business and taking a cue from payers, who are aggressively pursuing an infomediation strategy and cutting providers out of the cycle.

Jeffrey Rideout of the Integrated Healthcare Association was next up, making a direct connection between the influx of digital health venture funding and the challenges identified by Nate Kaufman and Paul Keckley. Jeff opened his talk by poking fun at the very term, digital health. “We don’t have ‘digital banking,’” he quipped; “we have banking that is digital. Eventually, health will be the same, and won’t need the unnecessary modifier of ‘digital’ because everything will be so.”

Jeff pointed out that of all the 1,700+ digital health companies funded in the past five years, almost all of them focus on providers. While there are some payer solutions, especially around member engagement and exchanges, these are few and far between. This is in large part because payers have insourced their innovation strategies in entities like Aetna’s Healthagen and United’s Optum. Providers, in turn, are faced with both the burden of sifting through these thousands of options for ones that work, and the opportunity to find best-in-breed solutions that would otherwise be hard to nurture inside their organizations.

Dr. Saum Sutaria from McKinsey rounded out the keynote line-up with an analysis of the 2015 ACA market, new insurance models such as provider-sponsored health plans, and the impact of the industry shift from B2B to B2C. The consumer market for healthcare is in its early stages, but one thing is clear: there’s a shocking disconnect between what consumers buy, and their understanding of what they bought. On the exchanges, consumers make their most important healthcare decision of the year without fully understanding the subsidies they were eligible for or the networks that they bought into.

He highlighted the key elements to a successful B2B-to-B2C transition: growing consumer control, increased transparency, personalization of service, and ultimately self-service. As this happens, an underlying infrastructure of decision-making tools and technology modules will become the norm. The question is just how long it takes to get there.

I was struck that even when technology wasn’t the speaker’s area of expertise, it unwittingly became the thread that connected each narrative together. (Or, so it seemed to me, viewing it through my health IT lens.) It reinforced why so many of our health IT clients attend our Summit: not only to reach this critical buying audience, but to glean insights into the evolving role of technology in addressing key business issues.

Next up, we’ll get into the juicy panel discussions around everything from provider-payer partnerships, to specialty care models, to data-enabled risk-sharing. Stay tuned for our second and final blog in this health technology-focused series.

November 17, 2015
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